摘要
目的探讨胰腺癌淋巴结转移对患者预后的影响，并评价用于预测胰腺癌患者术后生存期的指标。方法回顾2002年1月至2013年12月于我院行胰腺癌根治切除术的胰腺癌患者的临床资料，对是否有淋巴结转移、淋巴结清扫数、淋巴结阳性数、淋巴结阳性比率等因素分别进行统计分析。结果共有101例患者人选。患者6个月、1年及2年生存率分别为84．2％、56．6％和28．5％，中位生存期为13．8个月。单因素及多因素分析显示是否有淋巴结转移、淋巴结阳性比率、淋巴结清扫数及淋巴结阳性数是胰腺癌患者预后的独立影响因素。亚组分析显示，淋巴结清扫数是影响无淋巴结转移组患者预后的因素，而淋巴结阳性比率对淋巴结转移组患者生存期无影响。淋巴结转移可影响胰头癌患者生存期，但是对胰体尾癌患者则无明显影响。结论胰头癌患者淋巴结转移情况与预后密切相关，是否淋巴结转移、淋巴结清扫数、淋巴结阳性比率以及淋巴结阳性数是其预后的独立影响因素，但对淋巴结转移组患者，淋巴结阳性比率并不影响患者预后。
Objective To study the impact of lymph node metastasis on prognosis of patients with pancreatic cancer and to evaluate predictors of postoperative survival of these patients. Methods The clini- cal data on patients with pancreatic cancer who underwent pancreatic cancer radical surgery in our hospital from January 2002 to December 2013 were reviewed and analyzed. Data on lymph node metastasis, number of lymph node dissection, number of positive lymph nodes and positive lymph ratio were analyzed. Results Of 101 patients, the 6-month, 1-year and 2-year survival rates were 84.2% , 56.6% and 28.5%, respec- tively. The median survival was 13.8 months. Univariate and multivariate analyses showed lymph node me- tastasis, a positive lymph node ratio, number of lymph node dissection and positive lymph nodes were inde- pendent influential factors of prognosis. Results of subgroup analysis showed the number of lymph node dis- section was a prognostic factor for pN0 patients, while a positive lymph ratio had no impact on survival of pN1 patients. In the subgroup of patients with pancreatic head cancer, lymph node metastasis was associated with prognosis but not in the subgroup of patients with pancreatic body and tail carcinoma. Conclusions For patients with pancreatic head cancer, lymph node metastasis was closely correlated with prognosis. In addition, factors including lymph node metastasis, number of lymph node dissection, a positive lymph node ratio and number of positive lymph nodes were independent influential factors of prognosis for patients with pancreatic head cancer. However, for pN1 patients, a positive lymph node ratio has no influence on prognosis.
出处
《中华肝胆外科杂志》
CAS
CSCD
北大核心
2016年第10期672-676,共5页
Chinese Journal of Hepatobiliary Surgery
基金
上海交通大学医学院科技基金（14XJ10022）
关键词
胰腺癌
预后
淋巴结转移
Pancreatic cancer
Prognosis
Lymph node metastasis
